| NPI | 1063637577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2015008288) |
| Additional Taxonomies | 208800000X Urology (Licence: KS 0437820) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-12-18 |